Infertility Insurance Mandates: Morality or Regulatory Policy?

This paper compares two states to determine why Illinois has a law mandating insurance coverage for infertility treatment while Nebraska does not. Case studies employing legislative transcripts reveal the debates on mandate legislation differed on three points of comparison: the specifics of the legislation, the qualities of the sponsors, and the legislative outcomes. In Illinois, the mandate legislation included an IVF component, the sponsor was a Democrat, and the legislature passed the bill. In Nebraska, the mandate legislation did not include IVF, the sponsor was a Republican, and the legislature rejected the bill. What seems to have been an important difference was the nature of the proposed policy innovation. In Illinois, the mandate legislation included coverage for IVF, and that brought a morality theme to the debate. In Nebraska, IVF and other morally troublesome assisted reproductive technologies were left out of the legislation by the sponsor's design. Thus the debate had a decidedly more regulatory flavor. The paper places these results in an epidemiological framework and illustrates how qualitative investigation of the characteristics of policies, when conceived of as viruses, and of policy entrepreneurs and interest groups, when conceived of as vectors, can aid our understanding of policy diffusion. [ABSTRACT FROM AUTHOR]